There are several types of anesthesia available to provide control of pain and anxiety during your surgery. Each choice requires different preparation on your part. For your safety it is important that you read and follow the instructions carefully. if you are unclear about anything please ask your doctor.

For all surgery please wear comfortable, loose-fitting clothing. Tops/shirts should have sleeves that are easily drawn up above the elbow. When possible colored nail polish should be removed before surgery. Also remove earrings, necklaces and wrist watches.

You may have a light meal a few hours prior to surgery, although we suggest nothing to eat or drink for eight (8) hours prior to surgery as in preparation for IV general anesthesia (see Section D below). By doing so, if local anesthesia is not sufficient for your pain control, your procedure can still be completed that day with IV anesthesia. For more extensive procedures you may with to have someone drive you home. Plan to rest for a few hours after surgery. Unless the extraction is routine it may be best not to return to work that day.

1. Take the medication at the time directed before your surgery.
2. Follow instructions for any additional anesthesia chosen.

1. You may have a light meal four (4) hours prior to surgery. However, we would suggest following instructions for IV general anesthesia (see Section D below) in case general anesthesia is necessary.
2. You must have a responsible person to drive you home after surgery.
3. Plan to rest the remainder of the day.

Nothing to eat or drink (including water) for eight (8) hours prior to surgery. The exception is you should take any regular medications (high blood pressure, antibiotics, heart medicine, etc.), or any premedication prescription we may have provided, using only a small sip of water. You must have a responsible person to drive you home after surgery. Plan to rest for the remainder of the day. Do not operate power tools, machinery, etc., for 24 hours after surgery.

• Insulin dependent diabetics should receive special instructions from your oral surgeon. Please bring your Accu-check machine and insulin kit with you to the office on the day of surgery. Also, bring a light snack for recovery room if desired.
• Patients with asthma should bring their inhalers with them on the day of surgery.
• Cardiac patients who have Nitroglycerine should bring it with them on the day of surgery.

Our goal is to provide you with a safe, pleasant and effective anesthetic. In order to do this it is imperative that we have your full cooperation. Please feel free to call us with any questions concerning your surgery anesthetic.

You have had a surgical operation in your mouth that must be cared for just as an operation on any other part of your body. Please follow instructions carefully and if post-operative problems of an emergency nature occur always consult with the person most familiar with your surgical problem and therefore best able to render assistance -- your oral and maxillofacial surgeon. Our office number is listed above. 

1. Leave the gauze pad over the area of surgery for about 60-90 minutes. Hold it in place OVER THE SURGERY SITE by biting on the gauze with mild pressure. You may change and replace the gauze as needed every 20 minutes. Avoid constant spitting or rinsing of your mouth in order not to interfere with clot formation. A clot should form within a few hours after which you may gently remove the gauze pad and then use only as needed if bleeding recurs.

2. Some oozing is normal for a few hours after surgery. Should the oozing be persistent or heavy first rinse your mouth out thoroughly with warm water and remove any visible clot sticking out of the socket with a gauze pad or Q-tip. Place a gauze pad soaked in a strong tea solution or a moist tea bag over the bleeding area and apply pressure. To identify this area you may need a helper to examine your mouth with a flashlight. It is essential that the pad and pressure area are directly over the bleeding area. Apply continuous pressure for 30 minutes. Repeat this process two more times or until the bleeding stops. Avoid frequent changing of the gauze pad unless it becomes soaked. Remember, direct pressure is necessary to stop the bleeding. If bleeding still persists, then contact us at our office or through the paging service.

3. Try not to smoke for a period of five days after your surgery, however, the first 24 hours is the critical period. Remain quiet the day of surgery and get plenty of rest and do not engage in strenuous, dangerous or physical activities for three days after your surgery.

If you were given a prescription for pain, have it filled immediately and follow directions which will be on the label of the container. The tablet or capsule is to be SWALLOWED and not held in the mouth to dissolve. DO NOT take medication with an empty stomach or you may become nauseated. If the pain medication seems to cause nausea or vomiting, then discontinue its use and try using a non-prescription pain medication such as Tylenol, Advil or aspirin. If these do not provide adequate pain control or if nausea and vomiting persist, call us. Do not operate dangerous items/machinery or engage in dangerous work while taking pain medication. Do not drink alcohol or drive while taking pain medication.

When surgery has been done about the face, swelling or discoloration is not unusual; in fact, it's very common. ON THE DAY OF THE SURGERY, keep the face cold with periodic use of ice packs. Twenty minutes on and twenty minutes off is a good schedule to follow. Vaseline on the lips will help to avoid dryness. On the day after surgery start using warm salt water (1/2) tsp. salt in a glass of warm water) as a GENTLE mouth rinse after every meal and also between meals. START BRUSHING YOUR TEETH THE DAY FOLLOWING SURGERY. The operative area must always be kept clean. Swelling should reach its peak in 48 hours. A continued increase in swelling after the first 48 hours or elevated temperature following surgery should be assessed - so please call our office.

An adequate diet MUST be followed to insure a speedy recovery. Immediately following surgery, liquid or soft foods are recommended initially. As soon as you can, start a solid diet. We realize that the consumption of foods may be difficult, but an adequate diet is essential for proper healing. Sustacal, Carnation Instant Breakfast, Meritene, Nutrament or Ensure are helpful when used as liquid snacks. Soups and plenty of fluids and daily vitamins are also valuable. Do not eat very hard foods, such as rock candy, for about eight weeks. Jaw surgery may temporarily weaken the jaw making it more susceptible to fracture.

If "stitches" were placed in your mouth, it was to prevent excess bleeding and help hasten the healing. These will be removed easily and painlessly on your appointed day. Do not be alarmed if they become loose and a nuisance. Some of the "stitches" may work loose before your return appointment and usually this is not a problem to be worried about. Sometimes, dissolvable stitches are used and do not require removal. However, they may take several weeks to completely dissolve.

If you were given a prescription for an antibiotic, the directions must be followed closely! Infection can be a serious problem, and your antibiotic should treat and prevent infections. Unusual headaches, chills, a prolonged elevated temperature above 100º - (orally), neck pains, swelling, drainage, or pain must be investigated -- please do not hesitate to call us. If you were prescribed an antibiotic rinse please start it on the evening of surgery.

A dry socket is a delayed healing of the socket. Symptoms include a dull aching pain in the ear, chin, adjacent teeth, or jaw, beginning on about the third or fourth day after surgery and lasting an average of about ten days. It is usually accompanied by a foul taste. This is not an infection but a loss of the blood clot usually in a lower third molar or wisdom tooth socket. The cause is not known. Factors felt to increase the risk are smoking, medications such as birth control pills, increased age, difficulty of surgery and bad luck. Treatment is for the symptoms only. If pain medication does not satisfactorily control the symptoms, please notify us. Frequently, a medicated packing can be placed in the socket to alleviate the pain. This packing will need to be changed every three or four days until healing is complete.

1. If a denture or other prothesis was inserted following your surgery, DO NOT remove it for 24 hours or until you have been seen by us or your family dentist.
2. In some types of surgery, particularly surgery of "wisdom" teeth, a numbness may be experienced for days or even weeks after surgery. Do not become alarmed, this most probably is temporary and should gradually disappear.
3. If contact sports are planned ask us for advice as to when they can be resumed.
4. If you have had sedation or a general anesthetic, you should not drive a car or operate dangerous equipment for the remainder of that day and night.
5. The friend or family member who accompanied you should review your instructions with you and stay with you for six hours after your departure from the office.